The hip joint is a large strong ball and socket joint that also allows a considerable degree of movement in all directions.  It is one of the most significant joints in human development as it is where we started to stand upright from. We have evolved over many thousands of years to be on two feet all day and be physically active. Unfortunately today’s sedentary, sit-down society means that for most of the day our hips are not doing what they are designed for.

Diagnosis of problems in this region often centres on the location and behaviour of the pain. Cartilage injuries of the hip joint such as labral tears and chondral lesions often cause sharp ‘catching’ groin pain. Early identification of these problems is important as these injuries generally respond poorly to conservative treatment often requiring surgery.

Groin muscle (adductor) strains / tears are common in sport that involves sudden changes of direction or lunging movements and generally resolve quickly. On occasion however groin pain following muscle strains can become recurrent and long standing in nature. This is due to the close association the adductor muscles have with the muscles of low abdominal wall in which there has often been associated injury such as an abdominal hernia. The lumbar spine and joints of the pelvis can also refer pain to the groin and often this is a feature in these cases.

The most common underlying cause of hip and groin pain is weakness and lack of control of the gluteal muscles resulting in a combination of excessive forward and lateral tilting of the pelvis when running and walking. Since the hip joint socket is part of the pelvis any alteration in pelvis mechanics in the stance phase of walking directly increases stress to the hip joint, especially when you consider that impact forces in the hip joint when walking approach 3-4 times body weight.

Due to the highly integrated way muscles in the lumbar spine, pelvis and gluteal regions work consideration of the ‘core’ muscle function of the lumbar spine / pelvis region, and sitting and standing posture are important.

Treatment of these injuries may include manual therapy techniques to the lumbar spine and pelvis where appropriate, soft tissue therapy to tight muscles of the region, but the focus as always is on eliminating the underlying causes through specific exercises to improve gluteal muscle strength, and lumbar spine / pelvis ‘core’ stability.